MRI evidence for altered venous drainage and intracranial compliance in mild traumatic brain injury.
MRI evidence for altered venous drainage and intracranial compliance in mild traumatic brain injury.
复制标题
MRI证据证明了轻度创伤性脑损伤中静脉排水和颅内依从性的改变。
DOI：
10.1371/journal.pone.0055447
复制
发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Alperin N
中科院分区：
文献类型：
--
作者：
Pomschar A;Koerte I;Lee S;Laubender RP;Straube A;Heinen F;Ertl-Wagner B;Alperin N
比较轻度创伤性脑损伤（mTBI）受试者与年龄和性别匹配对照组的静脉引流模式和相关颅内流体动力学。30名成年受试者（15名mTBI患者和15名年龄和性别匹配的对照组）使用3T MR扫描仪进行调查。创伤后时间0.5 ~ 29年（平均11.4年）。对上颈部进行二维飞行时间磁共振静脉造影，以显示颈部静脉血管。通过脑动脉流入、静脉流出和颅脊髓液流量的电影相对比成像，得出第一和第二通道的脑静脉引流，颅内顺应性指数和压力。颅内顺应性指数定义为心周期内最大颅内容积与压力变化之比。然后通过依从性与ICP之间的反比关系获得MR估计的ICP。与对照组相比，mTBI患者通过颈内静脉流出的静脉比例明显降低（60.9±21%，对照组：76.8±10%,p = 0.01），通过次级静脉引流增加（12.3±10.9%，对照组：5.5±3.3%,p<0.03）。mTBI组患者的平均颅内依从性指数显著低于对照组（5.8±1.4比8.4±1.9;p<0.0007）。因此，mTBI患者的颅内压MR估计值明显更高（12.5±2.9 mmHg vs 8.8±2.0 mmHg; p<0.0007）。mTBI与继发性静脉引流增加有关。这反映了较高的流出阻抗，这可以解释颅内顺应性降低的发现。这些结果表明，即使在没有临床症状和常规磁共振成像异常发现的情况下，mTBI后的血液动力学和流体动力学变化仍然存在。
To compare venous drainage patterns and associated intracranial hydrodynamics between subjects who experienced mild traumatic brain injury (mTBI) and age- and gender-matched controls. Thirty adult subjects (15 with mTBI and 15 age- and gender-matched controls) were investigated using a 3T MR scanner. Time since trauma was 0.5 to 29 years (mean 11.4 years). A 2D-time-of-flight MR-venography of the upper neck was performed to visualize the cervical venous vasculature. Cerebral venous drainage through primary and secondary channels, and intracranial compliance index and pressure were derived using cine-phase contrast imaging of the cerebral arterial inflow, venous outflow, and the craniospinal CSF flow. The intracranial compliance index is the defined as the ratio of maximal intracranial volume and pressure changes during the cardiac cycle. MR estimated ICP was then obtained through the inverse relationship between compliance and ICP. Compared to the controls, subjects with mTBI demonstrated a significantly smaller percentage of venous outflow through internal jugular veins (60.9±21% vs. controls: 76.8±10%; p = 0.01) compensated by an increased drainage through secondary veins (12.3±10.9% vs. 5.5±3.3%; p<0.03). Mean intracranial compliance index was significantly lower in the mTBI cohort (5.8±1.4 vs. controls 8.4±1.9; p<0.0007). Consequently, MR estimate of intracranial pressure was significantly higher in the mTBI cohort (12.5±2.9 mmHg vs. 8.8±2.0 mmHg; p<0.0007). mTBI is associated with increased venous drainage through secondary pathways. This reflects higher outflow impedance, which may explain the finding of reduced intracranial compliance. These results suggest that hemodynamic and hydrodynamic changes following mTBI persist even in the absence of clinical symptoms and abnormal findings in conventional MR imaging.
登录
查看更多内容
影响因子：
3.3
作者：
Alperin, N;Lee, SH
通讯作者：
Lee, SH
影响因子：
9.9
作者：
Mayer, A. R.;Ling, J.;Yeo, R. A.
通讯作者：
Yeo, R. A.
影响因子：
4.4
作者：
Piccio, L;Rossi, B;Constantin, G
通讯作者：
Constantin, G
影响因子：
11
作者：
Jennett, B
通讯作者：
Jennett, B
影响因子：
4.4
作者：
Miyati, Tosiaki;Mase, Mitsuhito;Luechinger, Roger
通讯作者：
Luechinger, Roger